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首页> 外文期刊>Journal of hypertension >Effect of the renin-angiotensin system or calcium channel blockade on the circadian variation of heart rate variability, blood pressure and circulating catecholamines in hypertensive patients.
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Effect of the renin-angiotensin system or calcium channel blockade on the circadian variation of heart rate variability, blood pressure and circulating catecholamines in hypertensive patients.

机译：肾素-血管紧张素系统或钙通道阻滞对高血压患者心率变异性，血压和循环儿茶酚胺的昼夜变化的影响。

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OBJECTIVE: To determine the effects of 8 weeks of therapy with amlodipine, ramipril or telmisartan on the autonomic system over 24 h in hypertensives. METHODS: After a placebo run-in, 57 patients were included in a prospective randomized open-label design protocol for therapy with amlodipine (5 mg for 4 weeks followed by 10 mg for 4 weeks, n = 22), or ramipril (2.5 mg for 1 week, 5.0 mg for 3 weeks and 10 mg for 4 weeks, n = 17) or telmisartan (80 mg for 8 weeks, n = 18). Autonomic functions were assessed by norepinephrine (NE) and epinephrine (E), as well as by the spectral analysis of heart rate variability (HRV). RESULTS: The 24-h ambulatory blood pressure, plasma NE and HRV demonstrated the characteristic day-night circadian rhythm in hypertensives. Higher values for SBP and DBP and for NE levels, as well as for spectral analysis components - low frequency band (LF) and low frequency/high frequency (LF/HF) ratio - were found during the day, whereas the HF was higher during the night. In patients treated with amlodipine, the HF decreased significantly during the night, while the LF and the LF/HF ratio increased during the day in association with the rise in NE. The therapy with telmisartan did increase the HF during the night and the day, while ramipril did not influence all HRV components during the night but significantly increased the HF, and decreased the LF/HF ratio during the day. No changes were observed in plasma NE with telmisartan or ramipril, but a 50% increase in NE levels throughout the 24-h period was found in amlodipine-treated patients. CONCLUSION: These data suggest a sympathetic activation during the day and a decrease in parasympathetic activity during the night after therapy with amlodipine, correlated with increases in plasma NE. In contrast, the therapy with telmisartan significantly increased parasympathetic activity without changes in NE during the night and day. The therapy with ramipril increased the parasympathetic activity only during the day.
机译：目的：确定使用氨氯地平，雷米普利或替米沙坦治疗8周对高血压患者24小时内自主神经系统的影响。方法：安慰剂磨合后，将57例患者纳入前瞻性随机开放标签设计方案中，以氨氯地平（5 mg疗程4周，然后10 mg疗程4周，n = 22）或雷米普利（2.5 mg）治疗1周，5.0毫克3周和10毫克4周，n = 17）或替米沙坦（80毫克8周，n = 18）。通过去甲肾上腺素（NE）和肾上腺素（E）以及通过心率变异性（HRV）的频谱分析来评估自主功能。结果：24小时动态血压，血浆NE和HRV表现出高血压中典型的昼夜昼夜节律。白天发现SBP和DBP以及NE水平以及频谱分析组件（低频带（LF）和低频/高频（LF / HF）之比）的值较高，而在晚上。在氨氯地平治疗的患者中，HF在夜间显着下降，而LF和LF / HF比值在白天随着NE的升高而升高。替米沙坦治疗在白天和黑夜确实增加了HF，而雷米普利在夜间并未影响所有HRV成分，但在白天显着增加了HF，并降低了LF / HF比率。服用替米沙坦或雷米普利的血浆NE未见变化，但在氨氯地平治疗的患者中，整个24小时内NE水平增加了50％。结论：这些数据表明氨氯地平治疗后白天有交感激活，而夜间有副交感活性降低，这与血浆NE增加有关。相反，替米沙坦疗法在白天和黑夜中均显着增加了副交感神经活动，而NE没有变化。雷米普利疗法仅在白天增加副交感神经活动。

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